Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT LIB 3.5x24 389342435

Facility

$4,375.00

Hospital Charge Code	270639211C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBER 3.5x16mm 389351635

Facility

$4,375.00

Hospital Charge Code	270637375
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBER 3.5x16mm 389351635

Facility

$4,375.00

Hospital Charge Code	270637375
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERT 2 75x12 389341227

Facility

$4,375.00

Hospital Charge Code	270637896C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERT 2 75x12 389341227

Facility

$4,375.00

Hospital Charge Code	270637896C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERT 2 75x16 389341627

Facility

$4,375.00

Hospital Charge Code	270637895C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERT 2 75x16 389341627

Facility

$4,375.00

Hospital Charge Code	270637895C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERT 2 75X20 389342027

Facility

$4,375.00

Hospital Charge Code	270637490C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERT 2 75X20 389342027

Facility

$4,375.00

Hospital Charge Code	270637490C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERT 2 75x20 389342035

Facility

$4,375.00

Hospital Charge Code	270637881
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERT 2 75x20 389342035

Facility

$4,375.00

Hospital Charge Code	270637881
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 275x12 389341227

Facility

$4,375.00

Hospital Charge Code	270637896
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 275x12 389341227

Facility

$4,375.00

Hospital Charge Code	270637896
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 275x12 389341627

Facility

$4,375.00

Hospital Charge Code	270637895
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 275x12 389341627

Facility

$4,375.00

Hospital Charge Code	270637895
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 275x20 389342027

Facility

$4,375.00

Hospital Charge Code	270637490
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 275x20 389342027

Facility

$4,375.00

Hospital Charge Code	270637490
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 2 75x8 38934827

Facility

$4,375.00

Hospital Charge Code	270638260C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 2 75x8 38934827

Facility

$4,375.00

Hospital Charge Code	270638260C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 3 0x12 389341230

Facility

$4,375.00

Hospital Charge Code	270638462C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 3 0x12 389341230

Facility

$4,375.00

Hospital Charge Code	270638462C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 3 50x8 38934835

Facility

$4,375.00

Hospital Charge Code	270638460
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 3 50x8 38934835

Facility

$4,375.00

Hospital Charge Code	270638460
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

STENT LIBERTE 3 5x12 389341235

Facility

$4,375.00

Hospital Charge Code	270638315C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STENT LIBERTE 3 5x12 389341235

Facility

$4,375.00

Hospital Charge Code	270638315C
Hospital Revenue Code	278
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

Know your out-of-pocket cost for care.

All Charges